氢吗啡酮治疗急性和慢性疼痛。

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奎格利C

氢吗啡酮治疗急性和慢性疼痛。

Cochrane Database Syst Rev. 2002;(1):CD003447。

PubMed ID

11869661 (PubMed视图

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摘要

背景:虽然吗啡是治疗严重癌痛的金标准，但一些患者要么没有达到足够的镇痛效果，要么遭受无法忍受的吗啡相关毒性。对于这些患者，建议使用氢吗啡酮等替代药物。然而，我们对氢吗啡酮的功效和效力的理解似乎存在差距。目的:本综述探讨和评估氢吗啡酮在疼痛管理中的有效性的证据。检索策略:使用电子数据库和手工检索相关期刊寻找包括氢吗啡酮在内的随机试验。最近搜索日期:2000年2月。选择标准:纳入针对成人和儿童急性和慢性疼痛情况使用氢吗啡酮的随机对照试验。数据收集和分析:为回顾的目的设计了一个数据提取表格。使用Cochrane手册中描述的标准评估每个纳入试验的有效性。在分配隐藏的基础上为每项研究分配一个等级。 A checklist was used to assess blinding. MAIN RESULTS: Forty three studies (2725 subjects) were included in the review. Approximately half of these studies received a low quality score. In addition, the heterogeneity of the studies precluded combination of data and results. A meta-analysis was therefore not possible. Of the 43 included studies, 11 (645 subjects) involved chronic pain conditions (all cancer) and 32 (2080 subjects) acute pain. Three studies were placebo-controlled. Of the remainder, hydromorphone was compared with other opioids (morphine, fentanyl, sufentanyl, meperidine, oxycodone, diamorphine), bupivicaine and with itself, using different formulations. The routes of administration included intravenous, oral, spinal, intramuscular and subcutaneous. Overall, hydromorphone appears to be a potent analgesic. The limited number of studies available suggest that there is little difference between morphine and hydromorphone in terms of analgesic efficacy, adverse effect profile and patient preference. However, as most studies involved small numbers of patients, it is difficult to determine real differences between both drugs. In the context of both acute and chronic pain, the issue of equi-analgesic ratios between morphine and hydromorphone was not resolved. REVIEWER'S CONCLUSIONS: The studies included in this review were varied in terms of quality and methodology. However, the majority demonstrated that hydromorphone is a potent analgesic, that the clinical effects of hydromorphone appear to be dose-related, and that the adverse effect profile of hydromorphone is similar to that of other mu opioid receptor agonists.

beplay体育安全吗引用本文的药物库数据

药物靶点

药物	目标	种类	生物	药理作用	行动
Hydromorphone	mu型阿片受体	蛋白质	人类	是的	受体激动剂	细节